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The Korean Journal of Pathology 2001;35(3): 263-266.
Superficial Endometriosis of the Uterine Cervix as a Source of Atypical Glandular Cells of Undetermined Significance in the Cervicovaginal Smear: A Report of Two Cases.
Hye Jeong Choi, Seung Koo Lee, Kyu Rae Kim
Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 138-736, Korea, krkim@www.amc.seoul.kr
ABSTRACT
Superficial endometriosis of the uterine cervix refers to a lesion in which endometrial stroma and/or gland is located immediately subjacent to the surface epithelium. The cells on the cervicovaginal smear shed from the lesion can be a significant source of atypical glandular cells of undetermined significance (AGUS), or can be easily mistaken for glandular dysplasia or adenocarcinoma in situ. Not infrequently it occurs at the conization site for cervical neoplasia. We describe the cytologic and histologic features of 2 cases of superficial endometriosis of the uterine cervix, which were discovered during an evaluation for AGUS detected on the cervicovaginal smears, with an emphasis on the utility of trichrome and reticulin staining for the diagnosis of superficial endometriosis. The cervicovaginal smears show sheets and clusters of glandular cells having mild to moderately pleomorphic oval nuclei with inconspicuous nucleoli and indistinct cytoplasmic border. Single cells or tumor diathesis were not present. Diagnostic histologic findings were the absence of thick or abundant collagen bundles, the encasement of individual stromal cells by a fine reticulin network and thick reticulin fibers around the spiral arterioles within the endometriotic foci. Therefore, superficial endometriosis should be considered as a potential source of AGUS, especially during follow-up after conization for cervical intraepithelial neoplasia.
Key Words: Vaginal smears; Cervix uteri; Endometriosis